Understanding Dental Code D0230

When to Use D0230 dental code

The D0230 dental code is a CDT (Current Dental Terminology) code used to report an intraoral periapical radiographic image—each additional image beyond the first. This code is essential when more than one periapical X-ray is required during a dental exam, such as when diagnosing the health of a tooth’s root or surrounding bone. Use D0230 only after the first periapical image has been billed with D0220, which covers the initial image. Proper use of D0230 ensures accurate clinical documentation and maximizes insurance reimbursement.

Documentation and Clinical Scenarios

Accurate documentation is critical for successful claim processing. When using D0230, clearly note in the patient’s chart the reason for each additional periapical image. Common clinical scenarios include:

• Evaluating multiple teeth for possible infection or trauma
• Monitoring endodontic (root canal) treatment progress
• Assessing bone loss or pathology in different areas of the mouth

Always include the number of images taken, the specific teeth or areas imaged, and the clinical justification for each. This level of detail supports medical necessity and helps prevent insurance denials.

Insurance Billing Tips

To optimize reimbursement for D0230, follow these best practices:

• Verify coverage: Before taking additional images, confirm the patient’s insurance policy covers multiple periapical X-rays per visit and note any frequency limitations.
• Use correct sequencing: Bill D0220 for the first image, then D0230 for each additional image. Do not use D0230 for the first image.
• Submit clear documentation: Attach clinical notes or radiology reports to the claim, especially if more than two images are taken.
• Review EOBs (Explanation of Benefits): If a claim is denied, check the EOB for denial reasons and be prepared to submit a claim appeal with additional documentation if needed.

Staying proactive with insurance verification and thorough documentation minimizes delays in accounts receivable (AR) and supports a healthy revenue cycle.

Example Case for D0230

Case: A patient presents with pain in the upper right quadrant. The dentist takes one periapical image of tooth #3 (billed as D0220), but also needs images of teeth #2 and #4 to assess the extent of possible infection. The additional images are billed as D0230 (one for each extra image). Clinical notes specify the symptoms, findings, and necessity for each image. The insurance claim includes all documentation, and reimbursement is processed without delay.

This example demonstrates how using D0230 correctly, paired with precise documentation, ensures both clinical quality and financial efficiency for the dental practice.